Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit in North Carolina
What 4 hospitals in North Carolina charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit (DRG 216), from 2024 Medicare claims.
Average charge
$379,006
Hospital list price billed
Average payment
$89,055
Medicare + patient + other payers
Medicare paid
$72,453
Average per stay
State rank
#6 of 20
1 = lowest average payment
Hospitals in North Carolina billed an average of $379,006 for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit, about 4.3 times the average total payment of $89,055. That payment is 17% below the U.S. average of $107,634.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $89,055Billed $379,006
About 23¢ was paid for every $1 hospitals in North Carolina billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in North Carolina:
North Carolina hospitals: cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit
Every North Carolina hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Duke University Medical CenterDurham | 28 | $298,142 | $95,183 | $77,641 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 24 | $451,551 | $78,397 | $67,061 |
| Carolinas Medical Center/Behav HealthCharlotte | 14 | $506,124 | $103,005 | $81,363 |
| Rex HospitalRaleigh | 11 | $264,775 | $78,957 | $59,671 |
Lowest and highest payments in North Carolina
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $78,397 |
|---|---|
| Rex HospitalRaleigh, NC | $78,957 |
| Duke University Medical CenterDurham, NC | $95,183 |
| Carolinas Medical Center/Behav HealthCharlotte, NC | $103,005 |
Highest
| Carolinas Medical Center/Behav HealthCharlotte, NC | $103,005 |
|---|---|
| Duke University Medical CenterDurham, NC | $95,183 |
| Rex HospitalRaleigh, NC | $78,957 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $78,397 |
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit in other states
Questions
How much does cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit cost in North Carolina?
In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit (DRG 216) at 4 hospitals in North Carolina was billed at $379,006 on average, while the average total payment was $89,055, of which Medicare paid $72,453. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in North Carolina, average charges were 4.3 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.